Introduction: A 38-yo male who was diagnosed with a thymoma in 2017 and had previously undergone ... more Introduction: A 38-yo male who was diagnosed with a thymoma in 2017 and had previously undergone chemotherapy and radiation presents with recurrent Superior Vena Cava (SVC) syndrome. Description: His initial presentation for his thymoma was with SVC syndrome. He then had enbloc resection of the thymic tumor in May 2018 in Washington D.C., which involved the innominate vein, SVC, pericardium, right phrenic nerve and right upper lobe of the lung. He again presented to his hematologist with recurrent SVC syndrome in March 2019 and opted to undergo treatment in Bethesda, MD. He underwent right thoracotomy, pleurectomy/decortication, resection of chest wall mass, sixth rib, and right diaphragm resection and reconstruction. He had an in-graft thrombus two days later and underwent catheter-directed thrombolysis with a TPA bolus in the IR suite followed by TPA drip in the MICU. He was subsequently discharged on apixaban. The patient again presented to the ED in May 2019 with facial plethora. Hematology and IR were consulted, and he was started on a heparin drip. His symptoms did improve after anticoagulation, but were not completely resolved. His cardiothoracic surgeon and IR team from Bethesda were consulted in order to better understand his complex anatomy. Vascular ultrasound was done and showed occlusion of the brachiocephalic vein and total chronic occlusion of left subclavian vein. CT angiography done on admission was a poor study as the contrast injected was consumed by extensive vessel collateralization. Repeat CT with contrast injected into the right arm showed occlusion of the SVC and possible clot. After much delay, he went to the IR suite, and no clot was found in his SVC; however, a stricture of the SVC graft near the distal anastomoses was found which was thought to be a result of radiation induced fibrosis. Therefore, balloon angioplasty was done. His symptoms resolved, and he was later discharged on therapeutic enoxaparin. Discussion: This case represents the complexity of SVC syndrome initially caused by a thymoma but had recurrences that were secondary to in-graft thrombosis and strictures of the SVC graft. This case was also complicated as the patient had 2 separate cardiothoracic surgeons and 3 separate IR teams in 3 separate states. His symptoms continue to progress at this time.
Traffic Clog is the main issue of the fast and evolving world. Due to the rise in the use of more... more Traffic Clog is the main issue of the fast and evolving world. Due to the rise in the use of more private vehicles and low road network capacity managing traffic with the traditional approach is cumbersome. Pollution and productivity of individuals are highly affected due to traffic. The use of mundane methods may not be an efficient and significant solution for varying traffic congestion. Nowadays, artificial intelligence (AI) and machine learning (ML) are playing an important role in solving many real-world problems. So, to tackle this problem, use of artificial intelligence and machine learning can give optimal solutions. An AI-enabled traffic management system can provide greater leeway to vehicles as they can then be directed and controlled more by the external environment. The main aim of using AI is to decrease manual interfacing. Various algorithms have been designed to curb this problem. The traffic management system consists of tools and technologies to gather information from heterogeneous sources. This study will help in identifying hazards that may potentially degrade traffic efficiency and its overcome technique. This article presents the detailed methodology, review, challenges, and future scope of the use of various algorithms for optimizing different aspects of Traffic Management System, i.e., Smart Traffic Signal Management, Traffic Flow Prediction, Traffic Congestion Detection, and its Management, and Automatic Detection of Traffic Signal.
Introduction The economic and social development of a country depends on the quality of its human... more Introduction The economic and social development of a country depends on the quality of its human resources, and the quality of human resources, in turn, depends on the quality of education and health services. Health, like education, is a " merit good, " which, if left to individuals, is generally under-consumed. This is so especially among the poor who have meager resources. Merit goods also have benefits that are not confined to the individuals who pay for it; the society at large also benefits. Health care being a merit good, private markets may restrict access. In India, the provision of health care is marred by class inequalities, the denial of opportunities to disadvantaged groups, low accessibility to the lower classes of society, and rampant corruption. The same trend is noticeable in Punjab (Government of Punjab 2004). Government must either provide health-care services or regulate their provision by the private sector to ensure equitable access particularly for ...
Policy transfer from one country to another has gained momentum during post-globalisation era. Em... more Policy transfer from one country to another has gained momentum during post-globalisation era. Empirical evidence, however, suggests that policy transfer is not always a smooth affair. The Indian experience, however, reveals that policy transfer automatically does not deliver the expected results. The outcome of policy transfer, in case of citizens' charter is very poor mainly due to the lack of political will, lukewarm response of the bureaucracy and absence of participation of stakeholders particularly frontline bureaucracy, citizens and civil society organisations in the formulation of citizen charters. GROWING BODY of Literature on policy transfer and lesson drawing suggests that countries across the globe are either importing policies and programmes from other countries or are remodelling their policies and programmes by drawing lessons from other countries. Dolowitz and Marsh have identified three forms of policy transfer. These include coercive policy transfers, normative policy transfers and mimetic policy transfer. Under coercive policy transfers the countries have no choice but to import policies. The policies of economic liberalisation and globalisation as a part of the structural adjustment programmes of the World Bank-IMF combine broadly fall in this category. The normative policy transfers are based on considered judgement of importing countries about the relevance of the policy transfer. Mimetic policy transfer happens when a country decides to imitate or import a policy, which has attained almost universal acceptance. Rose has identified five types of
Right to Information Act (RT/), 2005 is emerging as a potent weapon in the hands of citizens for ... more Right to Information Act (RT/), 2005 is emerging as a potent weapon in the hands of citizens for ensuring transparency and accountability in administration. The functioning of bureaucracy, which was shrouded in the veil of secrecy, was causing lot of harassment to the common man. The RT/ Act has brought relief to the much harried and harassed citizens. Even though these are the early days, it has started realising its potential. The Act contains 31 Sections, the crux lies in its Section 4, which makes it obligatory on the part of various public agencies to not only maintain its records in a set format, but also update it on a regular basis. It is believed that if the information is not maintained as per the provisions of the Section 4 by the concerned agencies, it will not be possible for them to provide the information to the information seekers. Therefore, it is important rather vital to ensure the compliance by various public organisations with the provisions contained in the Section 4 of the RT! Act, if the spirit of RT! is to be upheld.
Introduction: A 38-yo male who was diagnosed with a thymoma in 2017 and had previously undergone ... more Introduction: A 38-yo male who was diagnosed with a thymoma in 2017 and had previously undergone chemotherapy and radiation presents with recurrent Superior Vena Cava (SVC) syndrome. Description: His initial presentation for his thymoma was with SVC syndrome. He then had enbloc resection of the thymic tumor in May 2018 in Washington D.C., which involved the innominate vein, SVC, pericardium, right phrenic nerve and right upper lobe of the lung. He again presented to his hematologist with recurrent SVC syndrome in March 2019 and opted to undergo treatment in Bethesda, MD. He underwent right thoracotomy, pleurectomy/decortication, resection of chest wall mass, sixth rib, and right diaphragm resection and reconstruction. He had an in-graft thrombus two days later and underwent catheter-directed thrombolysis with a TPA bolus in the IR suite followed by TPA drip in the MICU. He was subsequently discharged on apixaban. The patient again presented to the ED in May 2019 with facial plethora. Hematology and IR were consulted, and he was started on a heparin drip. His symptoms did improve after anticoagulation, but were not completely resolved. His cardiothoracic surgeon and IR team from Bethesda were consulted in order to better understand his complex anatomy. Vascular ultrasound was done and showed occlusion of the brachiocephalic vein and total chronic occlusion of left subclavian vein. CT angiography done on admission was a poor study as the contrast injected was consumed by extensive vessel collateralization. Repeat CT with contrast injected into the right arm showed occlusion of the SVC and possible clot. After much delay, he went to the IR suite, and no clot was found in his SVC; however, a stricture of the SVC graft near the distal anastomoses was found which was thought to be a result of radiation induced fibrosis. Therefore, balloon angioplasty was done. His symptoms resolved, and he was later discharged on therapeutic enoxaparin. Discussion: This case represents the complexity of SVC syndrome initially caused by a thymoma but had recurrences that were secondary to in-graft thrombosis and strictures of the SVC graft. This case was also complicated as the patient had 2 separate cardiothoracic surgeons and 3 separate IR teams in 3 separate states. His symptoms continue to progress at this time.
Traffic Clog is the main issue of the fast and evolving world. Due to the rise in the use of more... more Traffic Clog is the main issue of the fast and evolving world. Due to the rise in the use of more private vehicles and low road network capacity managing traffic with the traditional approach is cumbersome. Pollution and productivity of individuals are highly affected due to traffic. The use of mundane methods may not be an efficient and significant solution for varying traffic congestion. Nowadays, artificial intelligence (AI) and machine learning (ML) are playing an important role in solving many real-world problems. So, to tackle this problem, use of artificial intelligence and machine learning can give optimal solutions. An AI-enabled traffic management system can provide greater leeway to vehicles as they can then be directed and controlled more by the external environment. The main aim of using AI is to decrease manual interfacing. Various algorithms have been designed to curb this problem. The traffic management system consists of tools and technologies to gather information from heterogeneous sources. This study will help in identifying hazards that may potentially degrade traffic efficiency and its overcome technique. This article presents the detailed methodology, review, challenges, and future scope of the use of various algorithms for optimizing different aspects of Traffic Management System, i.e., Smart Traffic Signal Management, Traffic Flow Prediction, Traffic Congestion Detection, and its Management, and Automatic Detection of Traffic Signal.
Introduction The economic and social development of a country depends on the quality of its human... more Introduction The economic and social development of a country depends on the quality of its human resources, and the quality of human resources, in turn, depends on the quality of education and health services. Health, like education, is a " merit good, " which, if left to individuals, is generally under-consumed. This is so especially among the poor who have meager resources. Merit goods also have benefits that are not confined to the individuals who pay for it; the society at large also benefits. Health care being a merit good, private markets may restrict access. In India, the provision of health care is marred by class inequalities, the denial of opportunities to disadvantaged groups, low accessibility to the lower classes of society, and rampant corruption. The same trend is noticeable in Punjab (Government of Punjab 2004). Government must either provide health-care services or regulate their provision by the private sector to ensure equitable access particularly for ...
Policy transfer from one country to another has gained momentum during post-globalisation era. Em... more Policy transfer from one country to another has gained momentum during post-globalisation era. Empirical evidence, however, suggests that policy transfer is not always a smooth affair. The Indian experience, however, reveals that policy transfer automatically does not deliver the expected results. The outcome of policy transfer, in case of citizens' charter is very poor mainly due to the lack of political will, lukewarm response of the bureaucracy and absence of participation of stakeholders particularly frontline bureaucracy, citizens and civil society organisations in the formulation of citizen charters. GROWING BODY of Literature on policy transfer and lesson drawing suggests that countries across the globe are either importing policies and programmes from other countries or are remodelling their policies and programmes by drawing lessons from other countries. Dolowitz and Marsh have identified three forms of policy transfer. These include coercive policy transfers, normative policy transfers and mimetic policy transfer. Under coercive policy transfers the countries have no choice but to import policies. The policies of economic liberalisation and globalisation as a part of the structural adjustment programmes of the World Bank-IMF combine broadly fall in this category. The normative policy transfers are based on considered judgement of importing countries about the relevance of the policy transfer. Mimetic policy transfer happens when a country decides to imitate or import a policy, which has attained almost universal acceptance. Rose has identified five types of
Right to Information Act (RT/), 2005 is emerging as a potent weapon in the hands of citizens for ... more Right to Information Act (RT/), 2005 is emerging as a potent weapon in the hands of citizens for ensuring transparency and accountability in administration. The functioning of bureaucracy, which was shrouded in the veil of secrecy, was causing lot of harassment to the common man. The RT/ Act has brought relief to the much harried and harassed citizens. Even though these are the early days, it has started realising its potential. The Act contains 31 Sections, the crux lies in its Section 4, which makes it obligatory on the part of various public agencies to not only maintain its records in a set format, but also update it on a regular basis. It is believed that if the information is not maintained as per the provisions of the Section 4 by the concerned agencies, it will not be possible for them to provide the information to the information seekers. Therefore, it is important rather vital to ensure the compliance by various public organisations with the provisions contained in the Section 4 of the RT! Act, if the spirit of RT! is to be upheld.
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